Humana bolstering chronic disease management service

The company plans to hire 270 additional employees to help serve 60,000 members starting in January.

By — Posted Sept. 29, 2010

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Humana is rapidly expanding a program to coordinate care of its chronically ill Medicare and commercial plan members.

Humana Cares, a chronic disease management service launched in 2009 as a small pilot program, will expand to serve 60,000 Humana members beginning in January 2011.

The company announced Sept. 14 that it will hire 270 employees this year to work at the St. Petersburg, Fla., office where Humana Cares is based. The office opened with 250 employees in February 2009 and will have 780 on staff with the new hires this year.

Humana Cares involves what the company calls a "multidisciplinary team" that coordinates members' care in cooperation with their physicians, pharmacies, relatives and "community resources."

A nurse assigned to each member becomes a guide through the health care system.

"The member's contact with and relationship with their physician doesn't necessarily change, though there is probably much more regular contact," said Humana spokesman Mitch Lubitz.

Mike McCallister, chair and CEO of Humana, told investors this year that the program cut costs by reducing members' acute care when tested on a smaller population of members. He said for those enrolled at least a year, hospitalizations dropped by 36% and emergency room visits decreased by 22%. Care outside the hospital also was down -- outpatient procedures by 14% and physician visits by 23%.

Humana has a financial incentive to keep those costs down, as it expects Medicare Advantage reimbursement rates to match standard Medicare in the coming years.

The company plans to spend 15% less on medical care for its Medicare Advantage members than traditional Medicare by closely managing their care and keeping them healthy.

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